The Impact of Bariatric Surgery on Short Term Risk of Clostridium Difficile Admissions

Overview

Journal Obes Surg

Date 2018 Feb 7

PMID 29404936

Citations 4

Authors

Hisham Hussan

Emmanuel Ugbarugba

Michael T Bailey

Kyle Porter

Bradley Needleman

Sabrena Noria

Benjamin ODonnell

Steven K Clinton

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Clostridium difficile infection (CDI) is major health care concern with reports linking it to obesity. Our aim was to investigate the little known impact of the two most common bariatric surgeries, Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), on risk of CDI admissions.

Methods: This is a retrospective cohort study using the 2013 Nationwide Readmission Database. We examined inpatient CDI rates within 120 days after RYGB (n = 40,059) and VSG (n = 45,394). In a time to event analysis we also evaluated inpatient CDI rates up to 11 months post-surgery. We chose morbidly obese patients that underwent non-emergent ventral hernia repair (VHR) as additional surgical controls (n = 9673).

Result: CDI rates were higher after RYGB than VSG in the first 30 days (odds ratio [OR] = 2.10; 95% confidence interval [CI], 1.05-4.20) with a similar but nonsignificant trend within 31-120 days. CDI rates were also higher after RYGB compared to VHR controls within 31-120 days after surgery (OR = 3.22, 95%CI: 1.31, 7.88, p = 0.01). In a time to event analysis with up to 11 months follow up, RYGB led to higher CDI compared to VSG (hazard ratio [HR] = 1.87; 95% CI, 1.12-3.13) with a trend towards higher CDI compared to VHR (HR = 1.95; 95% CI, 0.94-4.06). Similar CDI rates occurred after VSG vs VHR.

Conclusions: RYGB may increase the risk of CDI hospitalization when compared to VSG and VHR controls. This data suggest VSG may be a better bariatric choice when post-surgical CDI risk is a concern.

Citing Articles

Immunosuppression and Clostridioides (Clostridium) difficile Infection Risk in Metabolic and Bariatric Surgery Patients.

Morales-Marroquin E, Xie L, Uppuluri M, Almandoz J, de la Cruz-Munoz N, Messiah S J Am Coll Surg. 2021; 233(2):223-231.

PMID: 34015452 PMC: 8316288. DOI: 10.1016/j.jamcollsurg.2021.04.028.

2019 update of the WSES guidelines for management of () infection in surgical patients.

Sartelli M, Di Bella S, McFarland L, Khanna S, Furuya-Kanamori L, Abuzeid N World J Emerg Surg. 2019; 14:8.

PMID: 30858872 PMC: 6394026. DOI: 10.1186/s13017-019-0228-3.

Clostridium difficile and Laparoscopic Bariatric Surgery: an Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database.

Dang T, Dang J, Moolla M, Switzer N, Madsen K, Birch D Obes Surg. 2019; 29(6):1881-1888.

PMID: 30806914 DOI: 10.1007/s11695-019-03785-9.

The Type of Bariatric Surgery Impacts the Risk of Acute Pancreatitis: A Nationwide Study.

Hussan H, Ugbarugba E, Porter K, Noria S, Needleman B, Clinton S Clin Transl Gastroenterol. 2018; 9(9):179.

PMID: 30206217 PMC: 6134111. DOI: 10.1038/s41424-018-0045-0.

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